Neighborhood opportunity is associated with completion of hepatocellular carcinoma surveillance prior to the diagnosis of hepatocellular carcinoma in patients with cirrhosis - 13/11/24
Highlights |
• | The Ohio opportunity Index is a reliable, multidimensional tool used to quantify the effect of neighborhood opportunity on completion of hepatocellular carcinoma screening.Neighborhood opportunity has a dose-dependent effect on completion of hepatocellular carcinoma screening. |
• | Hepatocellular carcinoma screening adherence rate significantly increases in patients in the 87th percentile of neighborhood opportunity, highlighting a patient population could benefit significantly from targeted interventions to lower barriers to screening. |
• | Current Knowledge: |
• | Compliance with hepatocellular carcinoma screening is influenced by socioeconomic factors; however, the extent remains unknown. |
• | Adherence to hepatocellular carcinoma screening guidelines results in a diagnosis at earlier stages, allowing patients to be considered for curative treatment. |
Abstract |
Background |
The Ohio Opportunity Index (OOI) is a multidimensional metric used to quantify neighborhood-level resources to access a wide array of factors that influence health. This study examined the relationship between neighborhood opportunity and completion of guideline-concordant hepatocellular carcinoma (HCC) screening in patients with cirrhosis.
Methods |
This retrospective study included patients with cirrhosis and HCC who received care at The Ohio State University Wexner Medical Center between 1/1/2015 and 12/31/2021. High opportunity was defined as a score greater than the third quartile of the study cohort. Modified Poisson regression models with robust variance examined the association, on the prevalence ratio (aPR) scale, between guideline-concordant HCC screening and high neighborhood opportunity status.
Results |
This study included 157 cirrhosis patients newly diagnosed with HCC. Only 25.5 % of the patients completed HCC surveillance within 6 months prior to diagnosis. The OOI was a significant predictor of adherence in all models. For every ten-percentile increase in OOI score, there was a consistent increase in the prevalence ratio (PR) of pre-diagnosis HCC surveillance (PR=1.37, 95 % CI 1.10–1.71). This effect remained significant after controlling for sociodemographic, clinical, and cirrhosis-related variables (adjusted PR=1.38, 95 % CI 1.02–1.85. Compared to those with high OOI (i.e.,≥Q3), patients in the lowest opportunity quartile had a 64 % lower prevalence of HCC screening (PR=0.36, 95 % CI 0.26–0.50).
Conclusion |
Neighborhood opportunity status has a dose-dependent effect on HCC surveillance adherence in patients with cirrhosis. Future studies should identify neighborhood-level interventions to reduce socioeconomic disparities in HCC diagnosis and outcomes.
Le texte complet de cet article est disponible en PDF.Keywords : Cancer, Disparities, Surveillance, Socioeconomic, Ohio opportunity index
Abbreviations : AFP, aPR, CI, CT, EV, HE, HCC, INR, LI-RADS, MELD, MRI, OOI, PR, SBP, US
Plan
Vol 48 - N° 10
Article 102485- décembre 2024 Retour au numéro
Article précédent
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